Prevalence and clinical significance of solitary pulmonary sub-segmental microembolism

BACKGROUND: Solitary pulmonary microembolism is rarely discussed as a distinct diagnostic entity. The purpose of this investigation was to determine the prevalence and clinical significance of embolism limited to subsegmental branches in a group of patients discharged from hospital on anticoagulants with a diagnosis of pulmonary embolism based on ventilation-perfusion imaging followed by selective angiography. MATERIAL AND METHODS: Of 29 consecutive patients with classic signs of pulmonary embolism at angiography, we identified a subgroup of 5 patients with sub-segmental embolism, which was solitary in all cases. RESULTS: Clinical presentation included chest pain (2/5), shortness of breath (2/5, or hypoxemia (1/5). Chest X-rays were normal (2/5), or showed pulmonary oedema (1/5) or atelectasis with (1/5), or without (1/5) pleural effusion. VQ imaging patterns included small subsegmental mismatch (1/5), one segment mismatch (1/5), single (1/5) or triple (2/5) match. The site and size of the microemboli found at angiography were incompatible with the location and severity of symptoms in 4/5 (80%) patients, and with location and extent of Chest X-ray findings and with VQ patterns in all patients. VQ abnormalities were either either disproportionably larger or were non congruent with the vascular territory compromised by the subsegmental embolus. CONCLUSIONS: Sub-segmental pulmonary micro-emboli were always solitary, and not uncommon, comprising 17% of all patients with pulmonary embolism. The location and size of the emboli were inconsistent with clinical, Chest X-ray and scintigraphic findings, suggesting that isolated microemboli are a serendipitous finding, of no clinical significance

Age-related Changes in Auditory Cortex Without Detectable Peripheral Alterations: A Multi-level Study in Sprague–Dawley Rats

International audienceAging is often considered to affect both the peripheral (i.e. the cochlea) and central (brainstem and thalamus-cortex) auditory systems. We investigated the effects of aging on the cochlea, brainstem and cortex of female Sprague-Dawley rats. The auditory nerve threshold remained stable between the ages of nine and 21 months, as did distortion product otoa-coustic emissions and the number of ribbon synapses between inner hair cells and nerve fibers. The first clear signs of aging appeared in the brainstem, in which response amplitude decreased, with thresholds remaining stable until the age of 15 months, and increasing slightly thereafter. The responses of primary auditory cortex neurons revealed specific effects of aging: at 21 months, receptive fields were spectrally narrower and the temporal reliability of responses to communication sounds was lower. However, aging had a null or even positive effect on neuronal responses in the presence of background noise, responses to amplitude-modulated sounds, and responses in gap-detection protocols. Overall, inter-animal variability remained high relative to the variability across groups of different ages, for all parameters tested. Beha-vioral performance for the modulation depth of amplitude modulation noise was worse in 21-month old animals than in other animals. Age-related alterations of cortical and behavioral responses were thus observed in animals displaying no signs of aging at the peripheral level. These results suggest that intrinsic, central aging effects can affect the perception of acoustic stimuli independently of the effects of aging on peripheral receptors

Les substances neuroactives des systemes efferents de la cochlee

SIGLECNRS T Bordereau / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc

Vglut3 (un rôle essentiel dans la cochlée et implication dans la surdité DFNA25.)

Avant sa libération, le glutamate est accumulé dans des vésicules synaptiques par trois transporteurs vésiculaires (VGLUT1-3). Les cellules ciliées internes (CCI) de la cochlée n'expriment que VGLUT3. Pour étudier son rôle dans la physiologie cochléaire, nous avons utilisé une lignée de souris dont le gène Slc17a8, qui code pour VGLUT3, a été invalidé par recombinaison homologue. Les mutants ne présentaient pas de réponse nerveuse à une stimulation sonore. Les mécanismes d'exocytose des CCI étaient normaux et leurs synapses normales en microscopie électronique. Des immunoblots montraient que le transporteur membranaire du glutamate GLAST, ainsi que les sous-unités GLUR2 et NR1 des récepteurs AMPA et NMDA étaient toujours exprimées. Enfin, des potentiels auditifs du tronc cérébral étaient enregistrés après une stimulation électrique au niveau de la fenêtre ronde. Toutefois, nos résultats indiquent des diminutions de ~50% des synapses afférentes et de ~40% des neurones auditifs primaires ainsi qu'une réduction importante des terminaisons efférentes latérales sous les CCI.SLC17A8 est responsable de la surdité de perception non syndromique dominante DFNA25. Nous avons identifié une mutation dans l'exon 5 conduisant au remplacement de l'Alanine211 en Valine. Cette Alanine est conservée dans les VGLUT3 de différentes espèces ainsi que dans les VGLUT1-3 humains, suggérant un rôle fonctionnel important pour cet acide aminé. Nous avons caractérisé les propriétés biochimiques de la mutation A211V en culture de cellules. Le transporteur muté était correctement adressé aux boutons présynaptiques. Cependant, la mutation pA211V entraîne un défaut d'expression important en partie expliqué par le fait que le codon codant la valine est un codon rare. De plus, les études du transport de glutamate ont montré que la forme mutée est hyperactive par rapport à la forme native. L'ensemble de ces résultats montre que la mutation entraine un phénotype cellulaire complexe.Before its release, glutamate is accumulated into synaptic vesicles by three vesicular glutamate transporters (VGLUT1-3). Only VGLUT3 is expressed in the inner hair cells (IHCs) of the cochlea. To study its role in the hearing physiology, we used a mouse in which the Slc17a8 gene, which encodes VGLUT3, has been null-mutated. In this VGLUT3-/- mouse, no auditory nerve response to acoustic stimuli could be recorded. All the others cochlear potentials were normal. The genetic deletion of Slc17a8 in mice resulted in a profound deafness, without altering the IHCs synapse morphology and the synaptic vesicles turnover. Using western blot, we then observed that the glutamate-aspartate transporter GLAST and the GLUR2 and NR1 subunits of AMPA and NMDA receptors were always expressed. Finally, auditory brainstem responses could be elicited by electrical stimuli on the round window. However, VGLUT3-/- IHCs presented a ~50% loss of IHCs synapses and a ~40% loss of primary auditory neurons. The number of lateral olivocochlear synapses with primary auditory neurons dendrites was strongly reduced.The SLC17A8 gene is responsible for DFNA25, an autosomal dominant progressive, high-frequency nonsyndromic deafness. We identified a heterozygous non-synonymous missense mutation in exon 5, leading to the amino acid change p.A211V. The A211 residue is conserved in VGLUT3 across species and in all the human VGLUT subtypes (VGLUT1-3), suggesting an important functional role. We characterized the biochemical properties of the A211V mutation in cell culture. Our results suggest that the mutated VGLUT3 was correctly addressed at the presynaptic boutons. However, the pA211V mutation induced an expression decrease because the valine codon is a rare codon. Moreover, the glutamate uptake is increased with the mutated VGLUT3. All these results shows that this mutation involves a complex cellular phenotype.MONTPELLIER-BU Sciences (341722106) / SudocSudocFranceF

Glutamate receptor phenotypes in the auditory brainstem and mid‐brain of the developing rat

Glutamate receptors mediate most excitatory synaptic transmission in the adult vertebrate brain, but their activation in developing neurons also influences developmental processes. However, little is known about the developmental regulation of the subunits composing these receptors. Here we have studied age‐dependent changes in the expression of α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazole (AMPA) and N‐methyl‐d‐aspartate (NMDA) receptor subunits in the cochlear nucleus complex (CN), the superior olivary complex (SOC), the nuclei of the lateral lemniscus, and the inferior colliculus of the developing rat. In the lateral superior olive, the medial nucleus of the trapezoid body, and the ventral nucleus of the lateral lemniscus, the distribution of AMPA receptor subunits changed drastically with age. While GluR1 and GluR2 subunits were highly expressed in the first 2 postnatal weeks, GluR4 staining was detectable only thereafter. GluR1 and GluR2 immunoreactivities rapidly decreased during the third postnatal week, with the GluR1 subunits disappearing from most neurons. In contrast, the adult pattern of the distribution of AMPA receptor subunits emerged gradually in most of the other auditory nuclei. Thus, progressive as well as regressive events characterized AMPA receptor development in some nuclei, while a monotonically maturation was seen in other regions. In contrast, the staining patterns of NMDA receptor subunits remained stable or only decreased during the same period. Although our data are not consistent with a generalized pattern of AMPA receptor development, the abundance of GluR1 subunits is a distinctive feature of early AMPA receptors. As similar AMPA receptors are present during plasticity periods throughout the brain, neurons undergoing synaptic and structural remodelling might have a particular need for these receptors

Cochlear efferents in developing adult and pathological conditions

International audienc

Cysteine-string protein in inner hair cells of the organ of Corti: synaptic expression and upregulation at the onset of hearing

Cysteine-string protein is a vesicle-associated protein that plays a vital function in neurotransmitter release. We have studied its expression and regulation during cochlear maturation. Both the mRNA and the protein were found in primary auditory neurons and the sensory inner hair cells. More importantly, cysteine-string protein was localized on synaptic vesicles associated with the synaptic ribbon in inner hair cells and with presynaptic differentiations in lateral and medial olivocochlear terminals -- the cell bodies of which lie in the auditory brainstem. No cysteine-string protein was expressed by the sensory outer hair cells suggesting that the distinct functions of the two cochlear hair cell types imply different mechanisms of neurotransmitter release. In developmental studies in the rat, we observed that cysteine-string protein was present beneath the inner hair cells at birth and beneath outer hair cells by postnatal day 2 only. We found no expression in the inner hair cells before about postnatal day 12, which corresponds to the period during which the first cochlear action potentials could be recorded. In conclusion, the close association of cysteine-string protein with synaptic vesicles tethered to synaptic ribbons in inner hair cells and its synchronized expression with the appearance and maturation of the cochlear potentials strongly suggest that this protein plays a fundamental role in sound-evoked glutamate release by inner hair cells. This also suggests that this role may be common to ribbon synapses and conventional central nervous system synapses

Choline Acetyltransferase, Glutamate Decarboxylase, Tyrosine Hydroxylase, Calcitonin Gene-related Peptide and Opioid Peptides Coexist in Lateral Efferent Neurons of Rat and Guinea-pig

The lateral efferent (olivocochlear) innervation of the cochlea originates in the brainstem lateral superior olive. It is likely to use acetylcholine, gamma-aminobutyric acid, dopamine and various neuropeptides as neurotransmitters and/or neuromodulators. In order to determine the different coexistence patterns of these molecules in lateral efferent perikarya, we have used double and triple immunofluorescence co-localization techniques to colocalize choline acetyltransferase, glutamate decarboxylase, tyrosine hydroxylase, calcitonin gene-related peptide and enkephalins in single sections of the lateral superior olive. We also used a non-radioactive in situ hybridization technique onto serial sections of this nucleus to confirm the immunofluorescence co-localization data at the mRNA level. Whatever the pair or triplet of primary antibodies tested was, a high ratio of coexistence was observed in the immunofluorescence experiments. In triple co-localization experiments, 90-93% of the choline acetyltransferase-like immunoreactive neurons were also immunoreactive to the two other antigens investigated. The in situ hybridization co-localization data, based on the use of biotin-labelled oligoprobes, qualitatively confirmed these immunofluorescence data. In conclusion, it can be postulated that acetylcholine, gamma-aminobutyric acid, dopamine, calcitonin gene-related peptide, enkephalins and dynorphins (whose coexistence with choline acetyltransferase and enkephalins has been previously described immunocytochemically) coexist in lateral efferent neurons. Based on these results, it is tempting to propose the lateral efferent innervation as a useful model with which the functional implications of the coexistence of neurotransmitters/neuromodulators can be investigated in vivo

Pre-and postsynaptic M3 muscarinic receptor mRNAs in the rodent peripheral auditory system

International audienceThe medial and lateral efferent innervations originate from distinct parts of the superior olivary complex. Both use acetylcholine, respectively, to modulate the activity of outer hair cells (OHC), and spiral ganglion neurons (SGN) which are postsynaptic to the inner hair cells (IHC). Besides predominantly activating nicotinic receptors, acetylcholine recognizes muscarinic M3 receptors, whose the role(s) and cellular localization(s) are not yet firmly established. We used reverse transcription and polymerase chain reaction to amplify the M3 receptor cDNA in the rat and guinea pig organ of Corti and spiral ganglion. Then, we localized the M3 receptor mRNAs in cochleas and superior olivary complex of both species. The M3 receptor cDNA was amplified from samples of brain, organ of Corti and spiral ganglion. Indeed, its corresponding mRNA was localized in SGNs, OHCs and IHCs. However, in the apical turns, OHCs were often found unlabeled. In the superior olivary complex, M3 mRNAs were colocalized with choline acetyltransferase mRNAs in neurons of the lateral superior olive and ventral nucleus of the trapezoid body. These results suggest that the M3 receptor-induced inositol phosphate formation described in previous studies [21] takes place in both postsynaptic (SGNs, OHCs) and presynaptic components of efferent cochlear synapses, and in cells that are not contacted by efferents in the adult cochlea (IHCs)

Les récepteurs NMDA de la cochlée de souris (identification et régulation en conditions physiologiques et physiopathologiques)

MONTPELLIER-BU Médecine UPM (341722108) / SudocSudocFranceF